HomeMy WebLinkAboutSEP1975-00111SITE EVALUATION REPORT
,-JEFFERSON COUNTY HEALTH DEPT.
Multi -Service Building
802'Sheridan Avenue.
Port Townsend, Washington 98368
(206) 385-0722
Applica6r— Robin Pierce
Address: 31 Embody Road
,Port Ludlow. WA 98365
Telephone:
THIS REPORT DOES NOT CONSTITUTE APPROVAL OF A
BUILDING OR SEWAGE DISPOSAL PERMIT. THOSE
PERMITS SHALL BE GRANTED ONLY UPON APPLICATION
AND WILL BE REVIEWED IN ACCORDANCE WITH
CONDITIONS AND REGULATIONS EXISTING ON THE DATE
OF THE PERMIT APPLICATION. THIS REPORT IS NOT A
PERMIT APPLICATION.
M
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Receipt No: 6624
Fee:
Date:. 8/22/83
Sec. . 7 Twn. 28 Rg. lE
Lot 1 Whitter _ -
Lega( Description (Div.. e1k.. Lop
Directions for Locating Site (Draw map on back).
Site Size 1.6 acre
SaII&
Buyer --
I request this site evaluation for single family residence o evaluate existing system -------
2
2 bedroom mobile
INSTRUCTIONS: A minimum or two soil log holes at least 4 feet deep, 2 feet diameter, and feet apart must be dug in the proposed
drainfield area and flagged before the evaluation is made. See attached instruction shoot;;--
A
heets-
A site evaluation of the above property was made on __._ August 23, 1983
property has been found:
by this department and the
O ACCEPTABLE - Soil and site conditions are acceptable for installation of a sewage disposal system, as requested above, under'
existing conditions and regulations.
. r
❑ CONDITIONALLY ACCEPTABLE - Soil and site conditions are acceptable for installation of a sewage disposal system, as requested 93
above, under existing conditions and regulations, provided THE CONDITIONS SET OUT BELOW J
ARE MET. �?
0 UNACCEPTABLE - Soil and site conditions are unacceptable for installation of a septic tank system.
COMMENTS'
SOIL LOGS:
As of this date the system was functioning in an approved of manner.
Approximately 34' of the 150' of drainfield was under the mobile.
Resp,ecttully,
Hayes, R.S
ENVIRO ENTAL HEALTH S ECIALIST II
lob
' :
963 t•6�liue OLYMPIC HEALTHDISTRICT Peratit No,
Port Amel4s
SEWAGE DISPOSAL PERMIT APPtICATIQ14
-
I Sibmit in Duplicate Builds
0our ouse
Port;Townsftd Date
IONS, FOR LOCATING. SITE 2.14 %411
111*11*1CATION. IS HEREBY ME TO: INSTALL NFjW SYSTEM REI
lie 0
M��' �'tf BUILDING' 'N0. '2E'BEDROOM I BASEMENT 11 SITE SI2
DRAINFIELD IM=2rb OIDTH DEPTH
DRAW A DETAIjg PLOT PLAN BELOW, SEE INSTRUCTIONS, i .
_J
4-,
c
s
NG SYSTEM
.OF
M-Thm SIZE
M A'rw^�&=%ofam W."
PERMIT U
PRIOR APPROVAL'OELTAINED FROM THE HEALTH DEPARTMENT*
DATE CF INSTALIATION SIGNATURE CA
DATE
\ 2��INSPECTED By - DATE
SANITARIAN'S gommmw:
-I*CERTIFY THATTHISSYSTEM WAS INSTALLED IN THE MANNER APPROVED BY THE
HEALTH DEAlWMENT AAT
INSTALLERS NAME
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JEFFERSON COUNTY
INSTALLATION APPLICATION
Jefferson County Permit Center
Castle Hill Mall
621 Sheridan St.
Port Townsend, WA 98368
206-379-4450
PERMIT #....:BLD94-0235 DATE RECEIVED.:04/18/94
SITE ADDRESS:31 EMBODY RD
:PORT LUDLOW, WA 98365
-----------------------------------------------------------------------------
APPLICANT...:ROBIN PIERCE PHONE: 732-4278
MAILING ADDR:31 EMBODY RD
:PORT LUDLOW WA 98365
-----------------------------------------------------------------------------
PROPERTY OWNER: n PHONE:
MAILING ADDR..:
CONTRACTOR..: PHONE:
MAILING ADDR:
CONTR. LIC: EXPIRATION DATE:
PARCEL NO... :821073008
ALT: CON: Y NA:
LEGAL DESC..:STR 07-28-01
EWM, TAX #
WATER DATE:
_
LOT 1 , BLOCK , R. WITTER SP
S.:
SHOr,-6
BY:DATE :
DESCRIPTION OF IMPROVEMENT:
Move mobile to line up with
ga clear
drainf ield
-------------------------------------------------------------------------------
BUILDING TYPE ...... :MOB
BEDROOMS--- BATHROOMS--
MAIN FL...:
0
sf
TYPE OF IMPROVEMENT:ALT
EXIST.: 2 EXIST.: 2
ADDIL FL..:
0
sf
GARAGE/CARPORT.....:
PROP..: 0 PROP..: 0
HTED BSMT.:
0
sf
WOODSTOVE..........:
TOTAL.: 2 TOTAL.: 2
UNHT BSMT.:
0
sf
UBC OCCUPANCY GROUP:
SEWAGE DISP..:
CARPORT...:
0
sf
TYPE OF CONST......:
WATER SUPPLY.:PWELL
GARAGE....:
0
sf
UNITS.: 0 STORIES:O
HEAT TYPES.:
DECKS.....:
0
sf
DIMENSIONS:
-------MOBILE HOME------
COMMERCIAL:
0
sf
FRAME TYPE:
MAKE:KOZY YR:80
INDUSTRIAL:
0
sf
EST COST.$: 0
SIZE:24 X 56
BANK HT...:O
ft
PROJ GRP..: 5538
SH SETBACK:O
ft
-------------------------------------------------------------------------------
Owner/agent
----------------
FEES --------------
Signature:
type amount by date
recpt
PRMT $
75.00 AK 04/18/9491403
Date: _
B.C. $
4.50 AK 04/18/94
91403
Issued By:
Date:
---------------------
$ 79.50 TOTAL
Screen* 01
Parcel # 000821073008 Seo Cd 282107306231
R. WITTER SHORT PLAT
LOT 1
Mode* INQUIRY
Auto Roll: OFF
Nbad Cd 3315
* Taxpayer Cd PIER 2400 PIERCE, ROBIN M TO C.hg Dt 7/21/1989
* Title Owner T/P Chg Usr SR
Tax Code 0231 Status Tx TAXABLE Land Use 1101 MH-REALW/LND
Affidavit 59282 Vol/Page / C/U Code S/C Cd
I I n nen n Inn Inn inn r -nn A__ _ _ __ 1